The
sun is still below the horizon when we arrive. Three cars, many boxes of
supplies, five to ten people wearing scrubs, most of us women. Hazily,
as the coffee is still kicking in, we begin to set up treatment stations
on the hoods of cars and the beds of pickups. The parking lot we’re in
and the one across the street are sparking with activity as around one
hundred people, mostly men, mostly Latino day laborers, look for work in
the still-devastated city of New Orleans.

The men gather, ask each other what
vaccines they should get, share information about employers who don’t
pay, tell us about their families back in Texas, or Veracruz, or Bahia.
The wind picks up, sending gravel dust swirling around us, and people
chase after bandaids and alcohol swabs that took flight in the gust. A
regular comes by to show us how much better his leg is doing, and to ask
for some more vitamins. Someone else drops by to invite us to his
daughter’s quinceañera, her 15th birthday party. Several people
come for their final dose of hepatitis B vaccine; we’ve seen them off
and on for six months.

These Latino Health Outreach Project (LHOP) clinics are always busy, as
is every functional health care provider in this city, from the first
aid stations to the ERs. The terrifying reality in New Orleans these
days is that there is virtually no public health infrastructure, and so
our scrappy little clinic in the parking lot is, for some of our
patients, the option they feel safest with. Never mind the fact that we
can’t dispense medication, rarely have a doctor onsite, can’t do lab
work, or even full physical exams. We're here every Wednesday, we speak
our patients’ languages, we don’t ask about immigration status (or even
last names), and we do our best to respect the dignity of each of them.

Healthcare Needs

In the second week after Katrina hit, the Common Ground Free Clinic
opened in Algiers, an unflooded neighborhood on the west bank of the
Mississippi. At the time, it was one of only two places offering health
care in the region. A few weeks later, some of us began assessing
healthcare needs in the flood zones. We quickly realized that among the
many gaps in the city’s public healthcare infrastructure was a source of
culturally competent, bilingual healthcare for pre-Katrina Latino
residents, as well as the vast numbers of recently arrived workers.

We began setting up clinics on sidewalks and parking lots in areas where
mostly Latino workers were staying. Initially, the clinics consisted of
two of us giving tetanus shots and over-the-counter medications. Within
a few weeks, more providers were added, including MDs, nurse
practitioners, acupuncturists, and herbalists. We now do one clinic a
week early morning at a day-labor pick up site in downtown New Orleans,
one in a church out in suburban Kenner -- where we do limited primary
care and family medicine -- and we occasionally hold clinics at other
sites.

In addition to providing health care, we are committed to improving our
patients' access to healthcare across the city; supporting struggles for
justice for immigrants and working people; and building relationships
with organizations who have a history of working in New Orleans’ Latino
community, as well as with post-storm initiatives dedicated to
supporting residents’ right of return. At every step we charge ourselves
to remain accountable to and take leadership from local people and
organizations of color.

Before the storm, there were few Latinos in the city. As one national
day laborer organizer points out, “New Orleans and Pittsburgh were the
only two cities of their size in the country where race was almost
entirely a black and white issue. Both had remarkably small Latino
populations.” New Orleans’ outlying areas counted with seven percent
Latinos, but the city proper had only three percent prior to the storm.

New Context

Meanwhile, nine months after Hurricane Katrina, almost 60 percent of New
Orleans’ original residents have yet to return, as much of the city
still lacks basic services. The planning and reconstruction continue to
move forward without their input. This diaspora of New Orleanians still
scattered across the US -- who tend to be overwhelmingly African
American and lower-income than those who have made it back -- have no
assurance there will be housing, schools, hospitals, utilities -- not to
mention childcare, employment, and protection from future flooding if
they are to be able to return.

With such a large sector of the local labor force unable to contribute
to (and benefit from) the reconstruction of the city, it is no surprise
that workers are arriving in droves from other states and countries to
seek employment. They are black, Asian, white, and Latino; they come
from places as diverse as California and Texas, Colorado and Georgia,
Guatemala, Honduras, Peru, Brazil, and Mexico. These new workers have
arrived in a city with few Spanish speakers, little awareness of
immigrants’ needs and issues, and with five times as many agents from
Immigration and Customs Enforcement (ICE -- what used to be known as the
INS) as agents from the Department of Labor, who, in theory, enforce
labor laws.

In this new context, organizers see this situation as an historic
opportunity to build a multiracial workers' justice movement uniting
(mostly local) African-Americans and (mostly newly-arrived) Latinos.
Soon after the storm, the New Orleans Worker Justice Coalition, a
diverse group of organizers, advocates, residents, and service providers
based in New Orleans’ Latino and African-American communities, started
planning a multiracial workers’ center, whose vision is to use
organizing as a way to build bridges across race lines in a city where
people of color are beginning to be pitted against one another.

We are excited to be a part of this coalition because it allows our work
to concretely support organizing for workers' and immigrants' rights in
New Orleans, even as we maintain our role as healthcare providers, not
organizers.

In a way, we envision our clinics as a tool to help dissolve the barrier
between service provision and organizing that commonly exists. In the
absence of a functioning workers’ center, where ideally, service
provision, advocacy, and organizing would take place, our clinics are a
potential focal point for just such a hybrid of activity, support, and
leadership development. For now, the day laborer clinics serve as an
excellent connection point between our patients and the organizers from
the Worker Justice Coalition. At times, organizers have come to our
clinics to hand out know-your-rights materials or talk with workers
about upcoming events. We’d love to see our clinics serve as a steady
point of contact between workers and organizers as the work of the
coalition grows.

Significant Questions

Like most organizations that began in New Orleans after Katrina, we are
struggling with our own transition from a stop-gap emergency response
crew to a rooted, long-term community organization. We are facing
significant questions as we try to determine the future of our work and
how it fits into the service-vs-organizing paradigm. Do we see our
clinics ultimately as an organizing tool or as a valid source of primary
healthcare? Can we legitimately be both? How does our vision for our
clinics coincide with our patients’ needs, or their understanding of our
work? How does our limited capacity affect what we can provide?

We also find ourselves struggling with our relationship to Common Ground
Clinic, the free clinic out of which LHOP began, which is now one part
of a much larger organization of primarily white volunteers, mostly from
outside New Orleans. In the months after the hurricane, Common Ground
has received significant feedback from local, people-of-color-led
organizations concerning accountability to the larger struggle in New
Orleans, as well as a need to examine racism within the organization.

In recent months some Common Ground volunteers, with enormous support
from local African-American organizers from the People's Insitute for
Survival and Beyond and white allies from San Francisco's Catalyst
Project, formed an anti-racist working group, which has begun to do an
incredible amount of work shifting the organization to a more
accountable focus. LHOP coordinators work closely with the anti-racist
working group, and although the Common Ground Clinic and others hold us
up as a model within the organization of accountability and local
leadership, we recognize how far we still have to grow.

In addition to these challenges, over the last few months workers near
our day laborer clinic have been targeted by increasing police and ICE
harassment and arrest. Partially because of that, among other reasons,
workers are fanning out to other neighborhoods. This dispersal means
that a single mobile clinic can’t serve the majority of day laborers in
New Orleans, and that day laborer organizing itself will become more
challenging.

One Component

Meanwhile, we continue to face challenges finding reliable healthcare
providers for our primary care clinic in the church, which still lacks
lab services and other elements that could greatly increase continuity
of care for our patients. Finally, neither of these clinics are
ultimately the best options for patients who need more in-depth
services, such as acute care, women’s gynecological and prenatal care,
specialty care, or long-term monitoring.

We’re realizing that these realities are forcing us to make decisions
about where to direct our limited resources. At first, we thought we’d
have to do one of two things: invest more time and resources into our
church clinic, making it a viable source of bilingual healthcare for
Latinos in the Greater New Orleans area; or shore up the mobile clinics
and focus on using them as support for worker-led organizing. Now we’re
realizing that our ultimate path probably won’t fit firmly into either
category.

It’s been important for us to make these decisions in light of our
strengths and limitations, the relationships we have with patients and
other providers, and an awareness of the larger picture of healthcare
and community organizing, especially among Latinos and low-income
working people in New Orleans. Right now a feasible option for us is to
continue to build up our mobile clinics while maintaining a presence in
Kenner. In addition, since we know that many of our patients have
medical needs that stretch beyond the capacity of primary care, we are
beginning to build up a base of translators and patient advocates who
can accompany our patients to emergency rooms, prenatal care
appointments, and specialists.

Focusing more on the mobile outreach clinics also means that we can
begin to more concretely use these clinics as an organizing tool. Most
likely, this will begin happening in our health and safety trainings. We
have seen the interest among our patients when we have done safety and
environmental health trainings while we distribute protective gear for
workers involved in mold remediation, demolition, and house gutting. We
see this as a concrete capacity-building tool, a necessary service, and
a bridge to connect health issues with labor organizing. We’re excited
to expand that to include consistent legal trainings, wage-claim
support, and more.

Ultimately, we see our work as one component of a large, vibrant,
multifaceted movement for racial and economic justice in the Gulf Coast
and beyond.

Catherine Jones and Jennifer Whitney
are Louisianans who coordinate the Latino Health Outreach Project. Among
other fabulous things, Catherine is a third-year medical student and
Jennifer is a Wilderness EMT and a massage therapist. Both would like to
thank all our volunteers -- past, present, and future -- as well as our
advisors and mentors, and everyone who has given us their time, money,
resources, support, or advice along the way. Most of all we thank our
patients, whose dedication and generosity continue to humble and inspire
us. This article was first published in the Summer 2006 issue of
Left Turn
Magazine.